Staff Application

The Application Form - Please complete all the questions on the application form. Husbands and wives should complete separate applications.

Recent photo

Two completed Confidential Evaluation Reference Forms. (References are available online or can be emailed/faxed/mailed.)

You will need the following information to fill out this application:

your passport number and, if married, your spouse's passport number

dates and locations of previous YWAM experience

names and addresses of your references

your emergency contact information

your health insurance policy number, if applicable

your home church details

In case you lose your internet connection, we recommend typing your answers into a separate word processor and then pasting them into this application. That way, you will not lose all of your work if an error occurs.

If you have any questions or come across any problems completing the online application, please contact us by phone or email. 608-255-0500. You should receive an automated email confirmation when you complete the application. If you do not receive this email, please contact us, as it means we did not receive your application.

Personal Details

Which 360 Location
*

Full Name (as it appears on your passport)
*

First Name Last Name

Permanent Address:
*

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Current Mailing Address (if different)

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Add a Recent Photo
*

E-mail
*

Phone Number
*

-
Area Code Phone Number

Cell Phone Number
*

-
Area Code Phone Number

Driver's license number

Country and State of Issue:

Birth Date
*

Month Day Year

Birth Place
*

First Date Available
*

-
Month
-
Day Year

Best Way to Contact
*

Home Phone Cell Phone Email

Passport Information

Country of Citizenship:
*

Passport Number:
*

City and Country of Issue:
*

Date Issued
*

Month Day Year

Expiration Date:
*

Month Day Year

Visa Type: (if currently holding a U.S. visa):

Date Visa Issued:

Month Day Year

Date Visa Expires:

Month Day Year

City and Country of Issue:

Emergency Contact:

In case of Emergency contact:*

First Name Last Name

Relationship:
*

Address
*

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Home Phone

-
Area Code Phone Number

Cell Phone
*

-
Area Code Phone Number

Work Phone

-
Area Code Phone Number

E-mail
*

Marital Status:

Marital Status:
*

Married Single Widowed Engaged Separated Divorced

Spouse's Full Name:

First Name Last Name

Spouse's Birthday:

Month Day Year

Is your spouse planning to be on staff at 360 as well?

Yes No

Anniversary:

Month Day Year

If you have been separated or divorced, please explain:

Family History:

Do you have children?

Yes No

Name(s):

Age(s):

Passport Number(s):

Issued/ Expiration Date(s):

Your Parents' Names:
*

Parents' Address
*

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

How does your family, or those closest to you, feel about your decision to join the staff of 360?
*

Legal Information:

Are you involved in any current or pending lawsuits or legal proceedings?
*

Yes No

If yes, Please explain:

Have you ever been convivted of a felony?
*

Yes No

If yes, please provide a detailed explanation, including dates.

Have you ever been convicted of a sexual crime?
*

Yes No

If yes, please provide a detailed explanation, including dates.

Have you ever obtained psychological counseling?
*

Yes No

If yes, please provide a detailed explanation, including dates.

Military Service:

Are you or were you in any Military service?
*

Yes No

If so, please explain:

Financial Information and Accountability

Do you have monthly pledged support?
*

Yes No

How much do you currently have pledged in monthly support?
*

Do you presently have debt that would interfere with your long-term commitment?
*

Yes No

If yes, please explain:

If you do not have monthly support, how do you plan to support yourself if accepted as staff?

Church Information

Home Church:
*

Phone Number
*

-
Area Code Phone Number

Denomination
*

Pastor's Name
*

First Name Last Name

Church Address
*

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

What church leadership experience have you had, if any?

Are you presently ordained or liscensed as a minister?
*

Yes No

Work Experience

Please list your two most recent occupations.

Position:

Company:

Date of employment:

Month Day Year

Skills needed or acquired:

Position:

Company:

Date of Employment

Month Day Year

Skills needed or acquired:

What other skills, hobbies, or talents do you have?

Education Experience

What grade level have you completed in secondary/high school?
*

When did you graduate?
*

Name of Institution
*

Address of Institution
*

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Please list any other education you have recieved:

Health Information

Do you now, or have you ever received any compensation for disability from any source?
*

Yes No

If yes, please explain:

Do you have any physical impairments, handicaps or health conditions that require special attention? (We do not discriminate based on disabilities. We simply want to know how we could better serve you.)
*

Yes No

If yes, please explain:

Do you have medical insurance?
*

Yes No

Name of Insurer:

Medical Insurance number:

What does your medical insurance cover(briefly):

Missions Background and Interest

When and where did you complete your DTS
*

Have you ever been on staff with YWAM?
*

Yes No

If yes, list: (Position Location/Dates Supervisor)

If you were / are on YWAM staff, what is your direct supervisor’s name and contact information?

Spiritual History

What religious books and Christian magazines have influenced you most?
*

In your relationship with God, what has been your greatest help and hindrance in the past year?
*

What areas of your character are you presently seeking God to further develop and grow?
*

When you have completed the application, click "submit" below. (You may wish to copy/paste your longer responses in a word processor in case your connection is lost during the submission process.) After you click submit, Email us your extended ansewrs.